Evidence-based interventions found to reduce rapid repeat pregnancy and promote positive parenting skills for mothers living in foster care
Finigan-Carr, N.M., Murray, K.M., O'Connor, J.M., Rushovich, B.R., Dixon, D.A. & Barth, R.P. (2014). Preventing rapid repeat pregnancy and promoting positive parenting among young mothers in foster care, Social Work in Public Health, 30(1), 1-17.
Child welfare services in the U.S. have had a slow uptake of evidence-based programs that integrate parenting skills designed to mitigate closely spaced pregnancies for mothers living in out-of-home care. The demand for such support is elevated when considering the multiple factors that place adolescents living in out-of-home care at risk of pregnancy and rapid repeat pregnancy. This comprehensive literature review identified rigorously evaluated evidence-based programs that found positive results in preventing rapid repeat pregnancy and improving parenting outcomes in young parent service users. Programs examined were limited to U.S. samples operating within an urban population servicing primarily African American and/or Hispanic individuals.
The literature review utilized four prominent databases as well as specific narrowing or key terms to find articles. Further exclusion criteria limited the search to English, peer reviewed sources, and primary intervention studies published between 1996 and 2011. The use of a classification system entitled the California Evidence-Based Clearinghouse for Child Welfare (CEBC) was then used to determine quality and validity of research, as well as the effectiveness of each program. Post-exclusion, 23 articles remained, with 16 focusing on rapid repeat pregnancy and seven on parenting of infants. From the research, 22 interventions were identified, all of which were provided either in-home or in community-based settings.
Among programs reviewed, seven programs were revealed as being the most effective. The Family Growth Center (FGC) and Adolescent Parenting Program (APP) are two community-based programs with different approaches that demonstrate a reduction in rapid repeat pregnancy in service users, while Touchpoints and FAST (Families and Schools Together) used curriculum-based comprehensive services to promote positive parenting skills. The final three programs – the Nurse-Family Partnership, the Computer-Assisted Motivational Intervention and Black’s Home Visiting – provided home visiting interventions that worked to provide both outcomes of reducing repeat pregnancy and build positive parenting skills. It was recommended by researchers that foster programs in the U.S. integrate one of the identified programs as a service for mothers in care.
Limitations to the literature review included the exclusionary search protocol that exempted the use of gray literature and articles that were not eligible for CEBC rating. As well, research samples focused exclusively on mothers and did not incorporate services for young fathers. It was recommended by researchers to extend research and address this population as important factors in rapid repeat pregnancy reduction.